Andrew Wakefield and his wife, Carmel, arrive at the General Medical Council Photo: AFP/GETTY

This is quite a long post, and not funny at all. Sorry about that. I hope it's worthwhile.

Wakefield's role

Let's look at what he did. First, it has long been the case that he pushed his belief in the links between MMR and autism long after the evidence came back saying that there was none. Back in 1998 when his original Lancet article was published, it was not unreasonable to ask for more research; the measles virus was found in the guts of eight autistic children (out of a total group of 12) whose parents believed that the MMR "triple jab" had sparked the condition.

However, even at that stage, Wakefield went further, calling for the triple jab to be scrapped for single vaccines until "the issue had been resolved". This was despite good clinical reasons for giving the three together.

By 2002 there was pretty solid evidence that the MMR jab did not cause autism. But Wakefield continued to campaign for single jabs. It has since emerged that he earned £400,000 in fees as an expert witness for campaign groups preparing a lawsuit on behalf of parents of autistic children. He also owns the patent on a single vaccine, which he developed a few months before he called for the scrapping of the triple jab in favour of a single injection.

He has also been found guilty, following a fantastic piece of investigative journalism by Brian Deer of The Sunday Times, of unethical research behaviour, needlessly carrying out painful and invasive tests on autistic children, and bribing children at a birthday party £5 each to give blood samples. In the wake of the conflict-of-interest and unethical research findings, the Lancet retracted its original article. The GMC has struck him off for those findings, not for his stance on MMR.

The evidence

There were many large studies carried out, all of which failed to show any link between the vaccine and autism. A 2002 study of 500,000 Danish children in the New England Journal of Medicine found no links while a 2005 Cochrane Library meta-analysis also came back negative and reminded the world that: "Measles, mumps and rubella are three very dangerous infectious diseases which cause a heavy disease, disability and death burden in the developing world … [T]he impact of mass immunisation on the elimination of the diseases has been demonstrated worldwide." But the single most damning piece of evidence was this: autism levels didn't go up.

You may find this surprising, since we are constantly told that they are rising, but it is true. MMR was introduced in Britain in 1988. Hundreds of thousands of children were given it. If there is a link, we would expect a sudden rise in autism diagnoses. There was none.

Andrew Wakefield bears much culpability for the MMR scare. But he is far from alone; the MMR vaccine scare reveals a fundamental problem in the media reporting of science stories.

Every single "quality" national newspaper reported on the Lancet article and its repercussions eventually (even if only a few reported it the next day). For years, newspapers (including this one) reported any tiny case study which hinted at a link, while often ignoring huge meta-analyses and population studies that confirmed there was none. You can see why this happens – "vaccine may cause autism!" is a much better headline than "vaccine doesn't cause autism!". But while it is understandable, it is not excusable.

Further, a media obsession with "balance" is to blame. "Balance" in this case means the giving of equal weight to two opposing opinions. This can work in political journalism, but when talking about medical and scientific issues it generally involves having one person who "agrees with the science" – generally an expert in the field – and one who doesn't, which depressingly often means a crackpot or a conspiracy theorist. These two views do not have equal weight in the same way that those of a Government minister and his shadow might while talking about education or the NHS. But it achieves a minimal degree of objectivity – it is true that these two people said these things – so this shortcut approach to science reporting is often used by time-pressured journalists in search of a story. It is dangerous and inadequate, but I do not have a ready answer for how we could improve the situation.
The effect

Here's the money shot. Between 1998 and 2008, MMR uptake levels dropped from 92 per cent to 73 per cent. It is usually said that 85 per cent vaccine uptake levels are required for herd immunity – the point when diseases cannot spread in a population. A percentage of children are not susceptible to the inoculation, especially those with weakened immune systems, so in the absence of herd immunity, some children whose parents chose to vaccinate will still get the disease. This is why it is not solely a personal choice issue.

In 2008, 10 years after the scare and 14 years after its spread was halted in Britain, measles was declared endemic again in this country. There were a total of 1,348 cases that year, up 36 per cent from the previous year and up a staggering 2,400 per cent from 1998, when there were just 56 cases. About one in 10 measles cases leads to hospitalisation, and in rare cases encephalitis, blindness and even death.

And that, finally, is the cost of Wakefield's ethical failings and the media's wilful blindness. In 2006 a 13-year-old boy became the first person to die of measles in Britain since 1992, with a second child dying in 2008. There have also been deaths in Germany and elsewhere in Europe, and probably many, many more in the developing world (where other baseless vaccine and drug scares, around polio and HIV, are also wreaking a brutal havoc). Mr Wakefield, as he is now, and the British media must bear some responsibility for those deaths.

Update:

It's always the way – you spend a couple of hours writing a carefully thought-out piece about MMR, autism, media scares and Wakefield, and just after you publish it you find a brilliant online comic that says everything you wanted to say but in half the time and four times the wit. Please do go and feast your eyes on The Facts In The Case Of Dr. Andrew Wakefield, it's absolutely fantastic.